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003762 (BLCK)Sane ^ City Zip P.O. BOX 1504 No, 003762 Building Address J3"'3 ���,� 78-105 CALLIE ESTADO LA QUINTA, CALIFORNIA 92253 Owner .. City We>`sternriean Construction o. Sq. Ft. No. No. Dw. ' Mailing . BUILDING: TYPE CONST: OCC: GRP. Address P. ©. Box 1,379 - A.P. Number 774-071--004 Cityr9,2753 Address p Tel. City Zip , Legal. Description - • � • _ . Contractor . •.. . Project Description . � .. .. 80 Iona X 2'hicc'h retaini1Ziry GR -ry R^vninilds ++ of 3 of the Business and Professions Code, and my license is in full force and - effect. .`..A Address ,..WF i - SIGNATURE - +DATE Sane ^ City Zip Tel:' State Lic. City & Classif.' Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch:, Engr.,... .. .. - " Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lie. #- LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) Division ++ of 3 of the Business and Professions Code, and my license is in full force and - effect. .`..A SIGNATURE - +DATE " OWNER -BUILDER DECLARATION I hereby I Estimated Valuation affirm that am exempt from the Contractor's License Law for.the following _ reason: .(Sec. 7031.5,Business and Professions Code: Any city or county which requires a $If 200 permit to construct, alter, improve,* demolish, or repair any structure, .prior to its issuance also x requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Busine"ss and Professions Code,'or that -he is exempt therefrom, and the basis for the alleged Any Section 7031.5 by for Chk. Dep. - - exemption. violation of any applicant a permit subjects the applicant to a'civil penalty of not more than five hundred dollars ($500). " - •Plan Plan Chk. Bal., - -. O' I, as owner of the property, or my employees with wages as their sole. compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and :Const. • Professions Code: The Contractor's License Law does not apply,to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Mech. ' provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build,or improve for the purpose of sale.) 0. I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing. •struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law doesnotapply to an owner of property who builds or improves.fhereon, and who contracts for - S.M.I: such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading ❑ I am exempt under Sec. B. & P.C. for this -reason Driveway Eno. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION ' I hereby affirm that I have a certificate of consent to self -insure, or a certificate of • Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company - ❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished. TOTAL _ CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE. ;� -1 ,._ (This section need not be completed if the permit is for one hundred dollars ($100) valuation_ • or less.). .. .__ _ . I certify that in the performance of thg work for which this permit is'issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ' N :'• 1jEk`i2 7 i P U�: ; ¢ ;1 7_' 13 Date . Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become 10 (.Hd t1 :t f Lf f Ri. j �' x . Q _ BY: - subjecf to' the Workers" "Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. .ZONE: .MinimumSetback Distances: Front .Setback from Center.Line Rear Setback from Rear Prop., Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days.f f p '3/31/88 I certify that I have read this application and state that the above information is correct. - ' ISSued by: Date t 81 Permit I*agree to comply with all city and county ordinances and state laws relating -to building construction, and hereby authorize representatives of this city to enter the -above-. . mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES- EES1ST ISTFL. $0. FT. @ $ 2ND FL. SQ. FT. @ POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ. FT. @ WALL SO. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FO7RRMMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11/4 c SEWAGE DISPOSAL SQ.FT.GAR @ 3/ac HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FO7RRMMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FCIUN EINF. t� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. i BOND BEAM Ti, ATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING. FINAL INSPECTION CERT. OCG FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL